ASPIRIN USE AND CHRONIC DISEASES - A COHORT STUDY OF THE ELDERLY
ASPIRIN USE AND CHRONIC DISEASES - A COHORT STUDY OF THE ELDERLY
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DOI：
10.1136/bmj.299.6710.1247
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发表时间：
1989-11-18
影响因子：
105.7
通讯作者：
HENDERSON, BE
中科院分区：
文献类型：
--
作者：
PAGANINIHILL, A;CHAO, A;HENDERSON, BE
目的：评估阿司匹林的使用与心血管疾病、癌症和其他慢性病发病率之间的关系。设计.sbd.邮政问卷调查以了解阿司匹林使用的详细信息。背景.sbd.加州退休社区。所有22781名社区居民（白色，富裕，受过良好教育）被发送了一份问卷，其中包括病史和药物使用的问题，如止痛药，泻药，维生素补充剂。在所有61%的回应（13987，8881名妇女和5106名男子;中位数年龄73）。他们组成了一个队列，使用该地区三家医院的出院摘要和卫生部门的死亡证明进行了6年半的随访。只有13名受访者失访，但似乎没有死亡。主要观察指标：心血管疾病、癌症、消化道出血、溃疡和白内障的发生率在每天服用和不服用阿司匹林的参与者中进行比较。结果.sbd.年龄校正的发病率计算与内部标准和五个年龄组。截至1988年1月1日，所有参与者中有25例肾癌事件; 341例中风事件，253例急性心肌梗死，220例缺血性心脏病，317例其他心脏病，无心绞痛，心肌梗死或中风病史的受访者报告。与不服用阿司匹林的人相比，每天服用阿司匹林的人肾癌的发病率增加，尽管这种增加仅在男性中显著（男性的相对危险度= 6.3，95%置信区间为2.2 - 17，女性为2.1，0.53 - 8.5）。那些每天服用阿司匹林的人没有显示出任何其他癌症的风险增加，除了结肠癌的男女组合（相对风险= 1.5，1.1至2.2）。在经常服用阿司匹林的男性中，急性心肌梗死的风险略有降低，但女性没有。每日服用阿司匹林的人患缺血性心脏病的风险几乎是不服用阿司匹林的人的两倍（相对风险= 1.9，男性1.1至3.1，女性1.7，1.1至2.7）。在两种性别中均观察到卒中风险小幅、非显著性增加。结论：每天服用阿司匹林会增加患肾癌和缺血性心脏病的风险。
Objective.sbd.To evaluate the associations between the use of aspirin and the incidences of cardiovascular diseases, cancers, and other chronic diseases. Design.sbd.Postal questionnaire survey to elicit details of aspirin use. Setting.sbd.Californian retirement community. Subjects.sbd.All 22781 residents of the community (white, affluent, and well educated) were sent a questionnaire that included questions on medical history and the use of durgs such as analgesics, laxatives, and vitamin supplements. In all 61% responded (13987, 8881 women and 5106 men; median age 73). They formed the cohort that was followed up for 6 1/2 years using discharge summaries for three hospitals serving the area and death certificates from the health department. Only 13 respondents were lost to follow up but seemed not to have died. Main outcome measures.sbd.Incidences of cardiovascular diseases, cancers, gastrointestinal bleeding, ulcers, and cataracts were compared in participants who did and did not take aspirin daily. Results.sbd.Age adjusted incidences were computed with an internal standard and five age groups. By 1 January 1988 there has been 25 incident cases of kidney cancer among all participants; 341 incident cases of stroke, 253 of acute myocardial infarction, 220 of ischaemic heart disease, and 317 of other heart disease were reported among respondents without a reported history of angina, myocardial infarction, or stroke. The incidence of kidney cancer was raised among those who took aspirin daily compared with those who did not take it, although the increase was significant only in men (relative risks = 6.3, 95% confidence interval 2.2 to 17, for men and 2.1, 0.53 to 8.5, for women). Those who took aspirin daily showed no increased risk of any other cancer, except colon cancer for both sexes combined (relative risk = 1.5, 1.1 to 2.2). The risk of acute myocardial infarction was reduced slightly among regular users of aspirin in men but not women. The risk of ischaemic heart disease was almost doubled in those who took aspirin daily compared with non-users (relative risks = 1.9, 1.1 to 3.1, for men and 1.7, 1.1 to 2.7, for women). Small, non-significant increased risks of stroke were observed in both sexes. Conclusions.sbd.The daily use of aspirin increased the risk of kidney cancer and ischaemic heart disease.